This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.

Friday, December 19, 2014

Weekly Overseas Health IT Links - 20th December, 2014.

Note: Each link is
followed by a title and few paragraphs. For the full article click on the link
above title of the article. Note also that full access to some links may
require site registration or subscription payment.

Scott Mace, for
HealthLeaders Media , December 9, 2014

The Argonaut
Project that launched last week offers a real chance at much-needed workable EHR
standards. But by itself, Argonaut won't lead to interoperability nirvana.

In Greek mythology,
the Argonauts, accompanied by heroic Jason, had to snatch a golden fleece from
a dragon who never slept. In 2015, the Argonaut Project aims to snatch a true interoperability
demonstration between EHR competitors and help healthcare providers who've
spent many a sleepless night trying to figure out how they can survive in this
new age of sharing EHR data.

Announced at last
week's HL7 Policy Conference in Washington, the Argonaut Project has the
backing of heavyweight EHR competitors Epic, Cerner, McKesson, Meditech, and
athenahealth, as well as heavy-hitting providers Partners HealthCare in Boston,
Intermountain Healthcare in Salt Lake City, Beth Israel Deaconess Medical
Center in Boston, and Mayo Clinic in Rochester, MN.

Data from the
Centers for Medicare and Medicaid Services shows that as of Dec. 1, 2014, 1,681
hospitals and 16,455 eligible professionals have attested to Stage 2 meaningful
use.

That means less
than 35 percent of hospitals currently meet Stage 2 requirements and while
eligible professionals have until the end of February to report their progress,
only 4 percent of EPs have met Stage 2 requirements to date. The low
attestation numbers, presented during a Dec. 9 Health IT Policy Committee meeting, got the attention
of the College of Healthcare Information Management Executives which renewed
its call for CMS to immediately shorten the reporting period for 2015.

The U.S. Food and
Drug Administration is moving ahead with the Unique Device Identifier (UDI)
system to identify medical devices. Yet, the question remains: If FDA builds
the system, will the healthcare industry adopt it?

The agency is
working with manufacturers to launch the UDI system, which will be phased in
over several years. When fully implemented, the label of most medical devices
will include a unique device identifier in human- and machine-readable form. As
part of the implementation, device labelers will also submit certain
information about each device to FDA’s Global Unique Device Identification
Database, which the public will be able to search and download information.

Jeffrey Shuren,
M.D., director of the FDA’s Center for Devices and Radiological Health, says
that UDIs are “intended to streamline the monitoring of devices, improve safety
tracking and recall efficiency, and even make it easier to evaluate device
performance over time.” However, writing in a recent blog, Shuren acknowledges
that these benefits “will only become a reality when the UDI system is adopted
and integrated into the healthcare system—when
hospitals, doctors’ offices, patient registries, heathcare insurance companies,
and others incorporate UDI as part of their standard electronic health
information systems.”

With data breaches growing, 2015 promises to be
the healthcare industry's most challenging security year yet. These nine areas
demand attention in 2015.

Healthcare
organizations must tighten security or risk getting breached, penalized, and
potentially ostracized by a public fed up with seeming carelessness with their
personal information. Unfortunately, the task of securing protected health
information (PHI) is only becoming more challenging for even the best-prepared
organizations. Fitness bands, hospital portals, electronic health records,
health information exchanges, insurance networks -- the list of
Internet-connected devices, tools, and sites containing personal and medical
data keeps growing.

The healthcare
sector has been under attack for some time. In 2014, despite headlines
dominated by JPMorgan Chase, Home Depot, and other retail or financial
entities, the healthcare industry accounted for 43% of all major breaches,
according to the Ponemon Institute.

Having established
a level of trust and familiarity with electronic health records over the past
few years, increasing numbers of U.S. patients are looking for more advanced
features from their EHRs, according to a new survey from the National
Partnership for Women & Families.

The study, "Engaging
Patients and Families: How Consumers Value and Use Health IT," follows up
on a similar 2011 report that assessed consumer views toward EHRs. A lot has
changed since then, with more and more patients comfortable with the idea of
digitized records, and easier online access to health information spurring more
patient
engagement in their care.

In the past year,
more than four in five patients with online access to their health records (86
percent) used their online records at least once, according to NPWF; more than
half (55 percent) used them three or more times a year.

In the era of
patient engagement, patients are utilizing health IT tools to become more
active in their care.

Last year, 86
percent of patients used their EHR at least once, and 55 percent used them at
least three times a year, according to a study by National Partnership for
Women & Families.

The survey was a
follow-up to the organization's 2011 survey that aimed to assess consumer views
toward EHRs and health IT. The most recent survey repeated questions from the
2011 survey to identify and assess trends in consumer attitudes following
federal and state IT incentive programs, such as meaningful use.

"The demand
for health informatics workers is projected to grow at twice the rate of
employment overall, but there is strong evidence that the nation already faces
a shortage of qualified workers in this field," according to a new report
from research firm Burning Glass.

Moreover, the study
shows, job postings for health informatics personnel stay open long than others.

Employers are
struggling to fill many of these jobs, according to the Burning Glass. On
average, health informatics positions stay open for 35 days – two days longer
than the national average posting duration of 33 days.

The fiscal 2015
federal appropriations budget being finalized by Congress contains funds for
numerous health information technology initiatives under the Department
Veterans Affairs, Office of the National Coordinator for HIT and for rural
health, among other entities.

The Christmas time
bill is not particularly kind to ONC, granting a budget of $60, 367,000, the
same as in FY 2014. ONC had asked for $75 million in FY 2015, but the agency,
like others, generally requests more than it knows it will get.

In FY 2015, the
Small Rural Hospital Improvement Grant program is slated to get $14,942,000 for
quality improvement projects, adoption of telehealth services and coordinating
care between rural providers and VA’s VistA EHR, among other projects.

Interoperability is
the current health IT buzzword because it’s the essential ingredient in
creating a system that benefits patients, doctors and hospitals. Almost everyone
in healthcare is pressing for it and is frustrated, though probably not
surprised, that meaningful use did not get us
there.

The ONC says within
three years we’ll have a roadmap for providing interoperability “across vendor
platforms,” which should probably elicit a collective groan.

Look, a map is a
fine tool but of limited use if I don’t speak the language. Change in this
industry requires market drivers instituted now, if not sooner. We must move
from MU to a health care payment model driving True Interoperability, not the
garden-variety stuff.

The 2015-2020
Federal Health IT Strategic Plan just
released by the Office of the National Coordinator
for HIT is about “collecting, sharing, and using electronic health
information,” according to Seth Pazinski, director of ONC’s Office of Planning,
Evaluation, and Analysis.

Pazinski told a
Dec. 9 meeting of the Health IT Policy Committee that the draft five-year plan
outlines the federal government’s many HIT priorities established by 35
participating agencies “but there was a coming together around interoperability
as a top focus and priority.”

Adopting the IEEE
definition of interoperability—the ability of two or more systems or components
to exchange information and to use the information that has been exchanged—the
plan argues that “interoperable health information and health IT solutions will
lead to more efficient and effective health systems, better clinical decision
support, scientific advancement, and a continuously learning health system.”

The Office of the
National Coordinator for Health IT's updated
health IT strategic plan, released Dec. 8, is a high-level,
ambitious framework for the federal government. It addresses some of the
questions the industry has had about the direction of health IT and ONC. It's
also an interesting read.

The plans updated
goals include:

Expand
the adoption of health IT

Advance
secure and interoperable health

Strengthen
healthcare delivery

Advance
the health and wellbeing of individuals and communities

Advance
research, scientific knowledge and innovation

Clearly, the
strategic plan is a starting point, and the details still need to be hashed
out. But it raises a lot of questions in my mind.

Phishing emails try
to lure recipients into giving out information such as usernames, passwords or
credit card numbers. They also can give attackers ways to infiltrate the
enterprise network, according to an article in iHealthBeat by John
Moore of Chilmark.

"Phishing
emails often provide the entry point," Scott Koller, a lawyer at
BakerHostetler, says in the article.

Ryan Chiavetta, for
HealthLeaders Media , December 10, 2014

With the advent of
electronic health records in patient care, healthcare organizations have been
looking for a way to help physicians combat the deluge of mandates, while still
maintaining a high level of efficiency.

One fast-growing position designed to remedy this situation is the medical
scribe. A medical scribe's primary duty is to document a physician's encounter
with a patient in the electronic health record system. Scribes enter
information about a patient's history, the physical exam, the physician's
assessment, notes on decision making and discharge and after care instructions.

Sacramento,
Calif.-based Sutter Health has launched My Health Online for Teens, an
electronic health service which provides teens secure, online access to their
health records and their doctors.

My Health Online
for Teens also provides a way for parents to stay connected with the doctor of
their teens, as their children learn how to manage their own healthcare. The
platform lets kids ages 12 to 17 email their doctors, review test results,
renew prescriptions, track immunizations, and schedule appointments from a
cellphone or laptop.

California law
requires that some aspects of a teen’s medical care, particularly reproductive
and substance abuse services, be kept confidential once the child turns 12.
Rather than block parental access to the record entirely, in the Sutter
platform teens get full access to their personal health records. They can send
confidential questions or concerns directly to their doctors and view their
health data online.

There's plenty of potential for Google Glass in healthcare, despite
reports that have called into question the technology's value.

"Glass in the enterprise is certainly stronger than it's ever
been. Google is investing very heavily," said Kyle Samani, CEO of
Pristine, a company that develops software for the device, during a Monday
afternoon session at the mHealth
Summit outside Washington, D.C.

Samani was part of
a panel that included Paul Porter, MD, director of special projects and
telemedicine for Brown University Emergency Medicine, and Sean Lunde, mHealth
lead for Wipro's healthcare and life sciences consulting group. They noted
several use cases where Google Glass is being tested

Claire Read speaks to Dave Newton, the winner of the first ‘rising
star’ category of the EHI Awards, about his work on the myhealthlocker project
for South London and Maudsley NHS Foundation Trust.

8 December 2014

“I didn’t
originally start out with a big plan of going into healthcare informatics,”
admits Dave Newton, the winner of the ‘rising star’ category of the EHI Awards
2014.

In fact, his
initial career plan was to become a clinical psychologist. When health IT came
calling, he was working as a researcher at South London and Maudsley NHS
Foundation Trust, exploring the concept of recovery in older adults suffering
from mental ill health.

“I was speaking at
a conference about recovery,” he remembers. “And one of the professors from the
Institute of Psychiatry was talking around something called avatar therapy, which
they were just starting to pilot.

Earlier this year,
Congress enacted a one-year delay of the implementation of ICD-10-CM/PCS code
sets, extending the date from October 2014 to October 2015. This delay was
characterized by some as a bump in the road on the way to better health care
data.

Now, with some
physician groups advocating for an additional delay of up to two more years,
it's time for the industry to recognize that such obstruction is more than a
bump in the road. If the health care industry continues to delay ICD-10
implementation, we are careening toward a health care data disaster. Given that
the current system in use, ICD-9-CM/PCS, is inadequate for present-day uses and
that past delays have incurred significant costs, further delays will have
catastrophic consequences for the industry, with no measurable benefit. The
health care industry simply cannot afford any more delays in ICD-10
implementation.

The healthcare
industry will continue to be a vulnerable and attractive target for
cybercriminals in 2015, thanks to the expanding number of access points to
protected health information and other sensitive data via electronic health
records and the growing popularity of wearable technology.

That’s the
conclusion of Experian’s second annual Data Breach Industry Forecast, which
predicts that healthcare will continue to be plagued with data breaches in
2015. Healthcare organizations accounted for about 42 percent of all major data
breaches reported in 2014. “We expect this number will continue to grow until
the industry comes up with a stronger solution to improve its cybersecurity
strategies,” said Michael Bruemmer, vice president at Experian Data Breach Resolution,
in a written statement.

“Healthcare
organizations face the challenge of securing a significant amount of sensitive
information stored on their network, which combined with the value of a medical
identity string makes them an attractive target for cybercriminals,” states the
report. “The problem is
further exasperated by the fact that many doctors’ offices, clinics and
hospitals may not have enough resources to safeguard their patients’ PHI.”

The Office of the National Coordinator for Health IT (ONC) released
a five-fold federal health IT strategic plan, which focuses on widespread
health data sharing and looks beyond adoption of electronic health record (EHR)
systems.

The ONC's five-fold plan does include the expansion of health IT
adoption, particularly in the long-term care sector, but it also features the
advancement of an interoperable infrastructure, the strengthening of the
healthcare delivery system, the advancement of well-being of individuals and
communities, and the advancement of scientific research. The first two,
expansion of health IT adoption and advancement of interoperable
infrastructure, are the top priorities, says ONC. All of them require some kind
of interoperability push.

On a call announcing the plan, Karen DeSalvo, M.D., the National
Coordinator for Health IT, confirmed that there was a "big push for
interoperability" with this latest plan.

As it maps out ways
to better gather, share and put to use interoperable health data, the plan will
serve as a broad federal strategy, say ONC officials, helping
set the context for the Nationwide Interoperability Roadmap, which is
scheduled to be released January 2015.

That roadmap will
help to define the implementation of how the federal government can work with
the private sector to spur more widespread sharing of health data to improve
individual healthcare, drive better community and public health and advance
research.

As it maps out ways
to better gather, share and put to use interoperable health data, the plan will
serve as a broad federal strategy, say ONC officials, helping set the
context for the Nationwide Interoperability Roadmap, which is
scheduled to be released January 2015.

That roadmap will
help to define the implementation of how the federal government can work with
the private sector to spur more widespread sharing of health data to improve
individual healthcare, drive better community and public health and advance
research.

The Office of the
National Coordinator for Health IT's updated Federal Health IT Strategic
Plan, released today and spanning from 2015 to
2020, will focus on the collection, use and sharing of interoperable health
information.

The plan
"serves as the broad federal strategy setting the context and framing the
Nationwide Interoperability Roadmap that will be released in early 2015,"
according to an announcement from ONC.

In addition to
interoperability, the plan focuses on patient-generated data.

The mHealth Summit
kicked off Sunday at Maryland's National Harbor with provider engagement and
integration of mobile health technologies into healthcare among the major
themes.

"I believe we
will see mHealth devices become even more ubiquitous, driven by non-health-related
consumer companies--whom we can learn a great deal from in terms of making
health and wellness a part of our day-to-day lives," Rich Scarfo, director
of the event and vice president of its backer, the Personal Connected Health
Alliance, says at mHealth News.

A range of
stakeholders will chime in, including consumer electronics giants, pharmacy
chains and life sciences companies.

A California hospital has begun requiring certain patients use a
wearable remote patient monitoring device in order to comply with internal
patient safety protocols. Chino Valley Medical Center is employing the Leaf Patient Monitoring System from
Pleasanton-based Leaf Healthcare.

The sensor monitors
patient movement in bed, then uses that data to calculate when the patient
needs to be turned to prevent the formation of pressure ulcers. That data
is uploaded wirelessly to central monitoring stations or mobile devices so
clinicians can monitor the readings. The system also alerts nurses or staff when
a patient needs to be turned.

A recent clinical
trial showed that use of the sensor increased compliance with hospital turn
procedures from a baseline 64 percent to 98 percent. Ulcers are a dangerous and
painful condition which cost the US healthcare system $11 billion a year according to AHRQ, and because
they’re hospital-acquired, treatment is often not reimbursable by
insurers.

Alberta’s Health
Minister has struck a task force to investigate the creation of an integrated
provincial health information system after the College of Physicians and
Surgeons told a legislature committee this week the current system is “woefully
inadequate.”

Stephen Mandel has
chosen Alberta Health Services administrator Carl Amrhein to lead the task
force to look into the business case for a provincial clinical information
system and report back early in the new year, Mandel’s spokesman Steve Buick
said Friday.

“This is a group to
take a first look at it for the minister and get back to him quickly,” he said.
“The thinking is we need a single provincial system.”

Under the American
Recovery and Reinvestment Act's electronic health-record incentive payment
program, which has paid out nearly $25.8 billion since 2011, 94% of eligible
hospitals and 79% of eligible physicians have received payment for either
purchasing or meaningfully using a tested and certified EHR.

But the program
left gaps by not extending payments to behavioral health, long-term care and
other providers, said Dr. Karen DeSalvo, head of the ONC.
The ONC and other federal agencies are looking at ways to help these excluded
providers cover the cost of buying EHRs.